Articles Posted in Insurance

fees-300x254Ever noticed how tourists strolling our cities’ streets not only pause and peer into the windows of restaurants but they also invariably make a beeline for the menu posted out front? That’s smart consumerism, right, and so common sense that, hey, why doesn’t such price-checking work in medical care, too?

Well, think again: The nation’s in the midst of yet another experiment to try to make clearer and more transparent the soaring prices of medicine. With the dawn of 2019, Uncle Sam decided that hospitals needed to make available online their “chargemasters,” the giant list of their supposed prices for facilities, services, and prescription drugs.

Good luck, though, to consumers to find this important document, as required now by law, on hospital websites. Good luck, too, for patients in determining just what the sizable Excel spreadsheets mean for their finances and budgets.

When doctors, hospitals, insurers, and their captive lawmakers howl about how unfair malpractice lawsuits allegedly can be for modern medicine, patients who have suffered harms while seeking medical services should require loved ones, friends, and members of their community to view Bleed Out.

This new HBO documentary details the decade-long quest by comedian Steve Burrows and his family for justice for his mother, Judie. She was an energetic, retired teacher when she fell from her bike and needed emergency hip surgery. Before she had recovered, she fell again and needed a second operation. But this time, something went wrong: She lost more than half her blood, fell into a coma, and suffered irreversible brain damage that meant that she would spend the rest of her life in institutional care in rural Wisconsin.

dumbrella-300x256They look like nursing homes, but they’re not. And for the health and safety of our elderly loved ones, we must know the difference.

These so-called assisted living facilities, operating with much less regulation and oversight than nursing homes, are raising concerns about the safety and quality of their dealings with a growing number of elderly Americans. That’s because they’re full not only of older residents but also difficult — and costly to care for — seniors with dementia.

Jordan Rau, of the independent, nonpartisan Kaiser Health News Service, deserves credit for diving deep into rising complaints and documented harms to residents of facilities “originally designed for people who were largely independent but required help bathing, eating or other daily tasks.” These places, “unlike nursing homes … generally do not provide skilled medical care or therapy, and stays are not paid for by Medicare or Medicaid.”

acasite-300x160If you’re a resident of the District of Columbia and you qualify for help with your health insurance under the Affordable Care Act, don’t wait, you have until Jan. 31 to enroll in Obamacare. It’s still the law of the land and could benefit you and your loved ones, despite a sad and expected federal court ruling out of Texas that threatens the ACA and health coverage for tens of millions of Americans, yet again.

Eleven states and the District have extended Obamacare enrollment deadlines. Those deadlines have already passed in Virginia and Maryland. So, many in the area — along with the rest of the nation — will have to wait for what might be a while to see how the Texas case, brought by a group of Republican attorneys general and opposed by a group of their Democratic counterparts, gets resolved.

The legal elements of the case may be of interest to lawyers and policy wonks.

Although Good Samaritans deserve a great holiday cheer for their part in paying for some of it, medical debt persists as a giant shame of the American health care system. Doctors, hospitals, insurers, Big Pharma, and other providers and suppliers need to step up to shrink the financial burdens of medical care that crush far too many patients and their loved ones.

Judith Jones and Carolyn Kenyon, two retired friends in Ithaca, N.Y., raised $12,500 that they donated to a charitable group. It buys bundled, past-due medical bills and forgives them to help those in need. That became a powerful gift, as RIP Medical Debt leveraged it, buying for a penny on the dollar or so, a portfolio of obligations exceeding $1.5 million.

cjrbriefingbook-300x188Facts matter, and, when amassed in a smart way, they can paint a powerful and accurate picture of reality, as is made clear with findings presented in the annual “Briefing Book” on medical malpractice from the Center for Justice and Democracy at New York Law School.

As the Kentucky Supreme Court recently affirmed when it slapped down an attempt in the Bluegrass state to “reform” medical malpractice lawsuits, doctors, hospitals, nursing homes, and insurers too readily embrace and spread counter-factual notions about patients who seek in the civil justice system remedies for harms they have suffered while seeking medical services.

It’s our fundamental, guaranteed right to pursue such claims, the justices affirmed — and the CJ&D experts have put together research to show that medical malpractice cases don’t happen often but are valuable in protecting the quality and safety of all patients’ care.

HCGopen19-300x200Political partisans are whipping ahead with their Grinch-like views about public support of any kind for health care for less affluent Americans — and now the nation’s children are bearing the brunt of mean-spirited policies.

Georgetown University reported that for the first time in almost a decade, the number of children lacking health coverage increased, with roughly a quarter of a million more youngsters uninsured this year versus last.

Joan Alker, executive director of Georgetown’s Center for Children and Families, which has issued authoritative data on kids’ and health insurance, told NPR the increase of uninsured children is unacceptable, adding, “The nation is going backwards on insuring kids and it is likely to get worse.”

barbaraunderwood-300x300

NY Atty Gen Barbara Underwood

Profit-hungry hospitals have dived to some real lows in billing and mistreating patients. Seven New York facilities have gotten slapped down by the state attorney general for breaking the law by charging more than 200 women anywhere from $46 to $2,892 for collecting evidence that the patients may have been raped.

New York Attorney General Barbara Underwood, whose office conducted a year-long investigation of the abuses of state laws aimed at protecting victims of sexual violence, said in a statement, quoted by the New York Times: “Survivors of sexual assault have already gone through unfathomable trauma. To then subject them to illegal bills and collection calls is unconscionable.”

deskstanding-231x300Holiday gift-giving can be expensive, so the health-conscious may wish to exercise skepticism about some potential purchases with dubious or unexpected consequence.

If you’re considering forking over more than a few dollars, think twice about:

  • So-called “tall” or “standing” desks. They were supposed to be a response to growing research about workers’ heightened health risks from sitting all day long. But studies show that standing while working with a computer isn’t as beneficial as some advocates may have claimed. That’s because it isn’t exercise or movement — which was supposed to the point of promoting healthier workplace practices, such as getting up from the desk and walking around every few minutes rather than becoming sedentary on the job. Studies, in fact, show that workers who must stand all day suffer health harms, like varicose veins and more. Some employees with posture issues may benefit some from standing and not scrunching themselves up while sitting at a desk. For most of the rest of us, it does matter to get up, exercise, and move. A fancy desk isn’t necessary for that, right?

Last week’s election leaves two questions lingering about health care: Will politicians really hear what voters said? And, what help might beleaguered patients now expect from their elected officials?

The Affordable Care Act, the central flash point of almost a decade of bitter political battles, appears stronger and more steadfast with Republicans losing the House, despite their last-minute counter-factual claims to support pillars of Obamacare like protections on pre-existing conditions, minimum- and lifetime-benefits.

Medicaid, a program expanded under the ACA to provide more and more affordable care to the poor and struggling, got a big boost, too, in the midterms. Voters, by the ballot, voted to expand its reach in the “red-red” states of Utah, Nebraska, and Idaho. The new governor in Maine will halt her predecessor’s resistance to the Medicaid expansion, according to her campaign promises. In Wisconsin and Kansas, Democratic gubernatorial candidates who also campaigned for Medicaid expansion, defeated Republicans who had opposed it.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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